scholarly journals Tendon‐to‐bone healing after repairing full‐thickness rotator cuff tear with a triple‐loaded single‐row method in young patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
He-Bei He ◽  
Tao Wang ◽  
Min-Cong Wang ◽  
Hui-Feng Zhu ◽  
Yue Meng ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Clinical Outcomes ◽  
Bone Healing ◽  
Young Patients ◽  
Arthroscopic Repair ◽  
Young Cohort ◽  
Full Thickness ◽  
Postoperative Assessment ◽  
Constant Murley Score

Abstract Background Arthroscopic repair is recommended for young patients with full-thickness rotator cuff tears (RCTs), but the healing rates have raised concerns. The Southern California Orthopedic Institute (SCOI) row method has been developed based on greater than 3 decades of experience with excellent clinical outcomes; however, studies with a focus on the younger patient population are limited in number. The current study assessed the short-term clinical outcome and the initial tendon-to-bone healing in a young cohort after repair of a full-thickness RCT using the SCOI row method. Methods A retrospective cohort study was performed. Patients < 55 years of age who had a full-thickness RCT and underwent an arthroscopic repair using the SCOI row method were reviewed. Clinical outcomes were assessed at baseline, and 3 and 6 months post-operatively. The visual analog scale (VAS), University of California at Los Angeles (UCLA) scale, and Constant-Murley score were completed to assess pain and function. Active range of motion was also examined, including abduction and flexion of the involved shoulder. A preoperative MRI was obtained to assess the condition of the torn tendon, while 3- and 6-month postoperative MRIs were obtained to assess tendon-to-bone healing. Repeated measurement ANOVA and chi-square tests were used as indicated. Results Eighty-nine patients (57 males and 32 females) with a mean age of 44.1 ± 8.6 years who met the criteria were included in the study. Compared with baseline, clinical outcomes were significantly improved 3 and 6 months postoperatively based on improvement in the VAS, UCLA score, and Constant-Murley score, as well as range of motion. Greater improvement was also noted at the 6-month postoperative assessment compared to the 3-month postoperative assessment. Three- and six-month postoperative MRIs demonstrated intact repairs in all shoulders and footprint regeneration, which supported satisfactory tendon-to-bone healing. The mean thickness of regeneration tissue was 7.35 ± 0.76 and 7.75 ± 0.79 mm as measured from the 3- and 6-month MRI (P = 0.002). The total satisfactory rate was 93.3 %. Conclusions Arthroscopic primary rotator cuff repair of a full-thickness RCT using the SCOI row method in patients < 55 years of age yields favorable clinical outcomes and early footprint regeneration.

scholarly journals Tendon-to-Bone Healing after Repairing Full-Thickness Rotator Cuff tear with a Triple-Loaded Single-row Method in Young Patients

2021 ◽  
Author(s):  
He Bei He ◽  
Yong Hu ◽  
Min Cong Wang ◽  
Hui Feng Zhu ◽  
Yue Meng ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcome ◽  
Rotator Cuff Tear ◽  
Bone Healing ◽  
Young Patients ◽  
Full Thickness ◽  
Postoperative Assessment ◽  
Cuff Tear ◽  
Postoperative Mri ◽  
Constant Murley Score

Abstract Background: Arthroscopic repair has been recommended for young patients with full-thickness rotator cuff tear (RCT), but the healing rates raise concern. The SCOI (Southern California Orthopedic Institute) row has been developed over three decades of experience, which reported an excellent clinical outcome. However, studies that focus purely on a younger patient population remains limited in number. The current study aims to discuss the initial tendon-to-bone healing after repairing full-thickness RCT with SCOI row method in young cohort.Methods: Patients younger than 55 years who had a full-thickness RCT and underwent an arthroscopic repair with SCOI row method were reviewed. Clinical outcome were assessed at baseline, 3 and 6 months post-operatively. Visual analog scale (VAS), University of California at Angeles (UCLA) scale and Constant-Murley score were completed to assess pain and function. Active range of motion was also examined, including abduction and flexion of the involved shoulder. Preoperative MRI was performed to assess the condition of torn tendon, while postoperative MRIs in 3 and 6 months post-operatively were carried out to assess the tendon-to-bone healing. Repeated measurement ANOVA and chi-square test were used where applicable.Results: 89 patients (57 males and 32 females) who met the criteria were including in the study, with a mean age of 44.14 ± 8.638 years. Compared with baseline, clinical outcome was significantly improved in 3 and 6 months post operation, supported by improvement in VAS, UCLA score and Constant-Murley score, as well as range of motions. Greater improvement was also noted in 6-month postoperative assessment than 3-month postoperative assessment. Three- and six-month postoperative MRI demonstrated an intact repair in all shoulders, and regeneration of the footprint, which supported the manifestation of tendon-to-bone healing. The mean thickness of regeneration tissue was 7.35±0.76mm when measured in 3-month postoperative MRI, and 7.75±0.79mm in 6-month MRI, which showed statistical difference (P=0.002). The total satisfactory rate reached 93.3%.Conclusion: Arthroscopic primary rotator cuff repair of fullthickness RCT with SCOI row method in patients aged younger than 55 years provides excellent clinical outcomes and rapid regeneration of footprint.

scholarly journals Repair Integrity and Functional Outcomes after Arthroscopic Repair of Transtendinous Full-thickness Rotator Cuff Tears Minimum Two-year Follow-up

2017 ◽  
Vol 20 (4) ◽  
pp. 183-188
Author(s):  
Kyung Cheon Kim ◽  
Woo Yong Lee ◽  
Hyun Dae Shin ◽  
Young Mo Kim ◽  
Sun Cheol Han
Keyword(s):  
Los Angeles ◽  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Rating Scale ◽  
Clinical Results ◽  
Arthroscopic Repair ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Significant Difference ◽  
The University

BACKGROUND: To evaluate the clinical outcomes and associated repair integrity in patients treated with arthroscopic repair for a transtendinous rotator cuff tear followed by resection of the remnant rotator cuff tendon.METHODS: Between July 2007 and July 2011, we retrospectively reviewed patients who were treated for transtendinous full-thickness tears in the tendinous portion of the rotator cuff by arthroscopic repair. Clinical outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, the Shoulder Rating Scale of the University of California at Los Angeles (UCLA), the Constant-Murley score, a visual analogue scale (VAS) pain score, and range of motion (ROM). The repair integrity was determined by magnetic resonance imaging or ultrasonography.RESULTS: There were 19 shoulders with transtendinous full-thickness tears in the tendinous portion of the rotator cuff. The ASES, UCLA, Constant-Murley, and VAS pain scores showed significant improvements in function and symptoms (all p<0.001). The active ROM for forward flexion and abduction was also significantly improved (p=0.002 and p<0.001, respectively). The postoperative radiological examination showed cuff integrity without a re-tear in 68.4% of patients. However, the UCLA, ASES, and Constant-Murley scores were not significantly different between healed and re-torn group (p=0.530, p=0.885, and p=0.262, respectively).CONCLUSIONS: Although repair of transtendinous rotator cuff tears followed by resection of the remnant rotator cuff tendon in the footprint has a relatively high re-tear rate, no significant difference was observed in the short-term clinical results between the re-tear and healed groups.

scholarly journals Clinical Function Improves After Subacromial Injection of Local Anesthetic in Full-Thickness Rotator Cuff Tears: A Randomized Control Trial

2020 ◽  
Vol 8 (1) ◽  
pp. 232596711989233
Author(s):  
Brian Forsythe ◽  
Avinesh Agarwalla ◽  
Richard N. Puzzitiello ◽  
Bhavik H. Patel ◽  
Yining Lu ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Physical Examination ◽  
Range Of Motion ◽  
Rotator Cuff Tears ◽  
Controlled Study ◽  
Full Thickness ◽  
Randomized Controlled ◽  
Subacromial Injection ◽  
Constant Murley Score ◽  
Lidocaine Injection

Background: Rotator cuff pathology is the most common cause of shoulder pain in adults, accounting for nearly 70% of shoulder-related visits to clinicians. However, physical examination findings may be limited because of pain or patient inhibition. Purpose: To establish whether a relationship exists between pain, range of motion, and strength in patients with a full-thickness rotator cuff tear. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A single-blind, randomized controlled study of 40 patients undergoing rotator cuff repair for full-thickness rotator cuff tears was performed. Patients were randomized to receive either a subacromial 10-mL 2% lidocaine injection or a sham injection, with no contents being injected into the subacromial space. Before the injection, patients were assessed using a visual analog scale for pain (VAS-Pain) as well as the Constant-Murley subjective questionnaire and objective physical examination. The examination was repeated 10 minutes after injection and 6 months postoperatively. VAS-Pain after injection was not assessed. The assessment at 6 months was performed to demonstrate improvement of rotator cuff function after operative management. Statistical analysis included Student t and chi-square tests as well as multivariate binomial logistic regression analyses to identify predictors for improvement after injection. Results were considered significant if P < .05. Results: Range of motion, strength, and Constant-Murley score significantly improved after a subacromial lidocaine injection ( P < .05). Range of motion, strength, Constant-Murley score, and VAS-Pain significantly improved at final follow-up compared with the preinjection assessment for both groups ( P < .05); however, there was no difference ( P > .05) between groups at 6 months postoperatively. Conclusion: After subacromial lidocaine injections, patients exhibited modest but significant improvements in range of motion, strength, and the Constant-Murley score. Pain may limit range of motion and strength in patients with full-thickness rotator cuff tears independent of the mechanical impact of the tear itself. Registration: NCT02693444 ( ClinicalTrials.gov identifier).

scholarly journals The Effect of Different Starting Periods of Passive Exercise on the Clinical Outcome of Arthroscopic Rotator Cuff Repair

2014 ◽  
Vol 17 (2) ◽  
pp. 57-63 ◽  
Author(s):  
Young Woong Back ◽  
Suk Kee Tae ◽  
Min Kyu Kim ◽  
Oh Jin Kwon
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Clinical Outcomes ◽  
Exercise Group ◽  
Arthroscopic Repair ◽  
P Value ◽  
Passive Exercise ◽  
Group I ◽  
Post Operation ◽  
Group Ii

BACKGROUND: To compare the effect of different starting periods of rehabilitative exercise (early or delayed passive exercise) on the rate of retear and other clinical outcomes after the arthroscopic repair of the rotator cuff.METHODS: In total, 103 patients who underwent arthroscopic repair of the rotator cuff were included in the study. Determined at 2 weeks post-operation, patients who were incapable of passive forward elevation greater than 90degrees were allotted to the early exercise group (group I: 79 patients; 42 males, 37 females), whilst those capable were allotted to the delayed exercise group (group II: 24 patients; 14 males, 10 females). The group I started passive exercise, i.e. stretching, within 2 weeks of operation, whilst group II started within 6 weeks. The results were compared on average 15.8 months (11-49 months) post-operation using the passive range of motion, the Visual Analog Scale (VAS) pain score, and the University of California at Los Angeles (UCLA) and Constant scores. Stiffness was defined as passive forward elevation or external rotation of less than 30degrees compared to the contralateral side. Follow-up magnetic resonance imaging (MRI) was carried out on average 1 year post-operation and the rate of retear was compared with Sugaya's criteria.RESULTS: There were no differences between the two groups in gender, age, smoking, presence of diabetes, arm dominance, period of tear unattended, pre-operative range of motion, shape and size of tear, degree of tendon retraction, and tendon quality. There were no significant differences in clinical outcomes. Whilst stiffness was more frequent in group II (p-value 0.03), retear was more frequent in group I (p-value 0.028) according to the MRI follow-up.CONCLUSIONS: During rehabilitation after the arthroscopic repair of the rotator cuff, the delay of passive exercise seems to decrease the rate of retear but increase the risk of stiffness.

scholarly journals Outcome and Structural Integrity of Rotator Cuff after Arthroscopic Treatment of Large and Massive Tears with Double Row Technique: A 2-Year Followup

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Ignacio Carbonel ◽  
Angel A. Martínez ◽  
Elisa Aldea ◽  
Jorge Ripalda ◽  
Antonio Herrera
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Functional Outcome ◽  
Rotator Cuff Repair ◽  
Structural Integrity ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Double Row ◽  
Massive Rotator Cuff Tears ◽  
Cuff Repair

Purpose. The purpose of this study was to evaluate the functional outcome and the tendon healing after arthroscopic double row rotator cuff repair of large and massive rotator cuff tears.Methods. 82 patients with a full-thickness large and massive rotator cuff tear underwent arthroscopic repair with double row technique. Results were evaluated by use of the UCLA, ASES, and Constant questionnaires, the Shoulder Strength Index (SSI), and range of motion. Follow-up time was 2 years. Magnetic resonance imaging (MRI) studies were performed on each shoulder preoperatively and 2 years after repair.Results. 100% of the patients were followed up. UCLA, ASES, and Constant questionnaires showed significant improvement compared with preoperatively (P<0.001). Range of motion and SSI in flexion, abduction, and internal and external rotation also showed significant improvement (P<0.001). MRI studies showed 24 cases of tear after repair (29%). Only 8 cases were a full-thickness tear.Conclusions. At two years of followup, in large and massive rotator cuff tears, an arthroscopic double row rotator cuff repair technique produces an excellent functional outcome and structural integrity.

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